A mixed methods evaluation of the unmet needs of early-onset colorectal cancer survivors.

PURPOSE: The incidence of colorectal cancer (CRC) is rising in people under age 50 (early-onset). Early-onset survivors face CRC during a critical point in their lives; many are establishing their families and careers. We sought to identify the unmet needs in a sample of early-onset CRC survivors and the resources they desired to address those needs. METHODS: We conducted a mixed methods study where participants completed the Cancer Survivors Unmet Needs (CaSUN) survey and a subsequent qualitative interview to expand on their unmet needs and desired resources. RESULTS: A total of 12 CRC survivors participated and 83% identified at least one unmet need, with an average of 13 unmet needs reported. Unmet needs were identified across every domain of the CaSUN measure, most commonly in the existential survivorship domain. Qualitative results demonstrated that survivors need more resources tailored for people their age and additional support for their families, including young children. CONCLUSION: Early-onset CRC survivors' needs are framed by the stage of their lives in which they are diagnosed, and the demand for interventions to support these survivors will continue to rise. The results of this study can inform future, tailored interventions for early-onset CRC survivors with substantial needs.

Perception of worry of harm from air pollution: results from the Health Information National Trends Survey (HINTS).

BACKGROUND: Air pollution exposure has been associated with a multitude of diseases and poses a significant concern to public health. For targeted environmental risk communication and interventions to be effective, it is important to correctly identify characteristics associated with worry of harm from air pollution. METHODS: Using responses from 3,630 participants of the Health Information National Trends Survey 4 Cycle 2, we assessed worry of harm from exposure to indoor (IAP) and outdoor (OAP) air pollution separately. Multinomial logistic regression models were used to calculate odds ratios and 95% confidence intervals. RESULTS: Hispanics were more likely to worry about harm from IAP and OAP compared to non-Hispanic whites. Participants who lived in metropolitan counties were more likely to worry about harm from IAP and OAP compared to those who lived in rural counties. Finally, those who believed their chance of getting cancer was high were more likely to worry about harm from IAP and OAP compared to those who thought their likelihood of getting cancer was low. CONCLUSIONS: Worry of harm from IAP and OAP varied across sociodemographic and cancer-related characteristics. Public health professionals should consider these characteristics when developing targeted environmental risk communication and interventions.

Impact of irrigation water type and sampling frequency on Microbial Water Quality Profiles required for compliance with U.S. Food Safety Modernization Act Produce Safety Rule standards.

The U.S. Food Safety Modernization Act (FSMA) Produce Safety Rule (PSR) requires that farmers generate a Microbial Water Quality Profile (MWQP) from 20 samples per agricultural water source, taken over 2-4 years and five annual samples thereafter. Farmers must use the MWQP to ascertain a geometric mean (GM) of ≤126 CFU/100 mL and statistical threshold value (STV) of ≤410 CFU/100 mL of generic Escherichia coli. Farmers are responsible for collecting samples and paying for testing, incurring a financial and time burden. To determine if testing frequency can be reduced without compromising accuracy, water samples (n = 279) were collected from twelve sites in the U.S. Mid-Atlantic region from 2016 to 2018 comprising tidal brackish river, non-tidal fresh river, pond, vegetable processing, and reclaimed water. The GM and STV were calculated for all sites and water types using all samples, and for multiple sub-samples of <20 from each site and water type. A Monte Carlo simulation was used to determine the proportion of sub-sample sizes that yielded the same determination as the entire sample size of PSR standard compliance. Four sites, two pond and two reclaimed water sites, complied with PSR GM and STV requirements when using the entire sample set. When a water source's calculated GM and STV using the entire sample set hovered close to the PSR thresholds, sub-sample sizes approached the recommended 20 samples to reach a congruent compliance determination. However, 99% agreement was obtained with a sub-sample of five when the absolute difference between the GM and STV from total samples and the PSR thresholds was ≥2.6 and 4.5 log CFU/100 mL E. coli, respectively. These findings suggest that under certain conditions the MWQP may be generated with well below 20 samples, reducing the economic burden on farmers while still maintaining a representative MWQP.

U.S. farmers' opinions on the use of nontraditional water sources for agricultural activities.

Water is a key resource for agricultural production in the United States. Due to projected changes in water availability across the country, long-term sustainability of agricultural production may rely on finding alternatives to traditional water sources. The aim of this study was to assess farmers' opinions on the use of nontraditional water sources (e.g., agricultural runoff, treated wastewater, recycled water, produced water, untreated surface water, and brackish surface and groundwater) for agricultural activities. A survey was distributed to farmers (n = 746) in the Mid-Atlantic and Southwest regions of the United States (U.S.) about water availability and nontraditional irrigation water perceptions. Chi-square, Fisher's exact tests, f-tests, and multinomial and ordinal logistic regression analyses were conducted. Of farmers surveyed, 80% (431/543) considered the use of nontraditional water sources to be at least moderately important and 61% (444/727) would use nontraditional water if given the option. Each of the following factors individually increased the likelihood that a farmer considered nontraditional water very important for agriculture: Farmers who lived in the Southwest region compared to the Mid-Atlantic, farmers who were concerned about water availability compared with those who were not, farmers with a graduate or professional degree compared to those with less education, farmers with access to nontraditional water, and farmers with some knowledge of nontraditional water compared to those with no reported knowledge. Concern about water availability and knowledge of nontraditional water sources were significantly associated with willingness to use these water sources (p < 0.001 for both). Water quality, food safety and health risks were the main concerns regarding nontraditional water use across both regions. Willingness to use nontraditional water increased significantly if the water quality was proven to be as good or better than farmers' current water sources (63% vs. 84%; p < 0.001). Projects focused on nontraditional water use in agriculture should be regionally tailored as our data found significant differences between farmers in two distinct U.S. regions.

Time Work by Overworked Professionals: Strategies in Response to the Stress of Higher Status.

How are professionals responding to the time strains brought on by the stress of their higher status jobs? Qualitative data from professionals reveal (a) general acceptance of the emerging temporal organization of professional work, including rising time demands and blurred boundaries around work/ nonwork times and places, and (b) time work as strategic responses to work intensification, overloads, and boundarylessness. We detected four time-work strategies: prioritizing time, scaling back obligations, blocking out time, and time shifting of obligations. These strategies are often more work-friendly than family-friendly, but "blocking out time" and "time shifting" suggest promising avenues for work-time policy and practice.

Work-family boundary strategies: Stability and alignment between preferred and enacted boundaries.

Are individuals bounding work and family the way they would like? Much of the work-family boundary literature focuses on whether employees are segmenting or integrating work with family, but does not explore the boundaries workers would like to have, nor does it examine the fit between desired and enacted boundaries, or assess boundary stability. In this study, 23 respondents employed at a large Fortune 500 company were interviewed about their work-family boundaries before and after their teams underwent a cultural change initiative that sought to loosen workplace norms and allow employees more autonomy to decide when and where they performed their job tasks. Four distinct boundary strategies emerged from the data, with men and parents of young children having better alignment between preferred and enacted boundaries than women and those without these caregiving duties. Implications for boundary theory and research are discussed.

GENDERED CHALLENGE, GENDERED RESPONSE: Confronting the Ideal Worker Norm in a White-Collar Organization.

This article integrates research on gendered organizations and the work-family interface to investigate an innovative workplace initiative, the Results-Only Work Environment (ROWE), implemented in the corporate headquarters of Best Buy, Inc. While flexible work policies common in other organizations "accommodate" individuals, this initiative attempts a broader and deeper critique of the organizational culture. We address two research questions: How does this initiative attempt to change the masculinized ideal worker norm? And what do women's and men's responses reveal about the persistent ways that gender structures work and family life? Data demonstrate the ideal worker norm is pervasive and powerful, even as employees begin critically examining expectations regarding work time that have historically privileged men. Employees' responses to ROWE are also gendered. Women (especially mothers) are more enthusiastic, while men are more cautious. Ambivalence about and resistance to change is expressed in different ways depending on gender and occupational status.

Social class and the experience of work-family conflict during the transition to adulthood.

The challenges of juggling work and family responsibilities are well known, but there has been little attention to the distinctive work and family experiences of young adults. This chapter explores how class affects young adults' exposure to work-family conflicts and the strategies they use to manage their work and family responsibilities. Using data from a recent cohort of young adults, we find class and gender variations in work and family roles and work-family conflict. Early family formation, coupled with poor working conditions, lead those with lower educational attainments to experience more years of family-to-work interference. In contrast, young adults with more education have more work-to-family interference, and this is especially true for college-educated women.